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What to know about heart surgeries

A cardiovascular surgeon with the Nizamiye Hospital, Abuja, Dr Mustafa Kirman, has advised people to always go to hospital when they have heart problems.

He said they should do so immediately they start having symptoms such as shortness of breath, irregular breathing, swelling of the ankle, and fatigue among others. He added that these are symptoms of heart failure.

He said any abnormal symptoms should not be taken lightly or waived aside as early diagnosis is key to preventing heart failure and death.

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“If a man starts having shortness of breath consistently, or heart palpitation, he should not just think ‘I am getting old. It is normal for me’. He should visit the hospital.

“Early diagnosis is very important because by the time the heart muscle is damaged or the patient comes too late, you cannot do anything.

“But, if you diagnose the disease on time, you can do some procedures to repair or replace the valve. If you are late, there is no success in the operation. You cannot protect the patient with better results. It is important to diagnose the disease early.”

He said when a person with heart problems visits a hospital, he or she first sees a cardiologist who diagnoses the problem and then together with a cardiac surgeon may decide on how to follow up the medical treatment, which could be interventional or require surgery.

Kirman, who has over 40 years’ experience in cardiac surgery and has done 15,000 heart surgery cases in Turkey, said contrary to popular belief, people can live normal life after heart surgery.

Asked if it is for all categories of patients, he said, “After surgery, patients can survive near-normal. They will take drug under doctor’s control. But they will live normally.”

He said common heart surgeries include coronary by-pass surgery, valve heart surgery and congenital heart surgery.

He said many Nigerians have cardiac diseases and need surgery but do not have the money for the surgery because the surgeries are usually very expensive.

“I see a lot of patients needing surgery, but do not have any money for the surgery – old people, cannot afford it if there is no insurance. It is a big problem,” he said.

He said valve problems are common in countries like Nigeria and Turkey but rare in developed countries like the USA.

He said the infection affects the heart valve over some years thereby leading to destruction of the heart muscle which further leads to heart failure, and then death.

The expert said coronary bypass surgery (open heart surgery) tops the number of heart surgeries he has done in Nigeria because there are a lot of coronary artery problems in the country.

He said he has done over 50 at Nizamiye Hospital alone. He said they were mainly done on adults but that the hospital plans congenital heart disease surgery in a few months.

He said the risk factors for coronary artery disease, were hereditary, high cholesterol, diabetes, hypertension, sedentary lifestyle, and obesity, among others.

The expert stressed that Nigerians should stop travelling abroad for cardiac surgeries. He said when people embark on cardiac medical tourism for open heart surgery for instance, they must do a follow up with their doctor.

He said, “These procedures of open heart surgery can easily be done here in Nigeria. Especially going outside for this procedure is quite expensive, and this is probably caused by people’s ignorance of such facilities in Nigeria.

 “After surgery, one month, two months, or  one year and  there is any problem with the surgery who will examine you?

“The surgery is just a component of the whole process. The doctor needs to check some indices, and markers after some months.

“So if you go out and do the surgery what about follow up?”

He said most people that died after heart surgery it was not because of the procedure, but because of follow-up.

“It is the post-care after the procedure. So it is safer to do it here, when you know that your doctor is just a phone call away from you.

“Thus, the operation is not the end point, after the operation, the follow up is the end point.

“We had instances where people who travel abroad for surgery, come here to do follow up. You cannot touch them because you do not know what was done in the heart of the patient. So it is a bit difficult to render services to such patients.

“This then makes the patient to incur another cost of travel. And mind you, you did an open heart surgery, subjecting yourself to cabin pressure in the air while flying and travelling long distance is not usually ideal.

“And if you decide to stay after the surgery, for like a minimum of six months that is a huge cost.

“So, it is safer for people to do the surgery here and have access to their doctor for the follow up, pending when he gives you a clean bill of health than traveling,” he said.

Dr Kirman advised people to go for cardiac checkups, at least once in a year if they are above 40 years.

“Cardiac checkup is necessary to detect the problem early,” he added.

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